Symptoms and Prescribing Requirements for Mood-Stabilizing Drugs
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Questions and Answers

What neurotransmitter dysfunctions are associated with symptoms of increased negative affect?

  • Serotonin (5HT) and norepinephrine (NE) dysfunction (correct)
  • Acetylcholine and glutamate dysfunction
  • Endorphin and oxytocin dysfunction
  • Dopamine and GABA dysfunction

    • What is required when prescribing mood-stabilizing drugs?

  • Baseline and routine laboratory monitoring
  • Pre-conception and contraceptive counseling for women of childbearing age
  • Product labeling for all antidepressants to contain information about potential risks of mania
  • All of the above (correct)

    • Which medication should be taken with at least 350 calories of food for maximum absorption and may be used as a second-line treatment for new-onset bipolar disorder in women who do not want to wait for long-term contraception or decide to get pregnant?

  • Lurasidone (correct)
  • Lithium carbonate
  • Lamotrigine
  • Valproic acid

    • For patients with renal failure who are prescribed lithium carbonate (Lithobid), what is the recommended starting dose adjustment?

    <p>The starting dose should be reduced by at least 50%</p> Signup and view all the answers

    Which drug classes can increase lithium levels?

    <p>NSAIDs and ACE inhibitors</p> Signup and view all the answers

    Which substance is mentioned in the text as decreasing lithium levels?

    <p>Caffeine</p> Signup and view all the answers

    Which labs should be monitored for a patient on lithium?

    <p>Serum lithium level, renal function, and thyroid function</p> Signup and view all the answers

    When does a patient need to return for lithium serum level monitoring after a dose increase?

    <p>The text does not specify a timeframe</p> Signup and view all the answers

    What symptoms are associated with increased negative affect due to 5HT and NE dysfunction?

    <p>Depressed mood, guilt, fear, anxiety</p> Signup and view all the answers

    What is a requirement for all antidepressants as per the FDA?

    <p>Information about potential risks of mania on product labeling</p> Signup and view all the answers

    Which drug class may be used as a second-line treatment for new-onset bipolar disorder in women who do not want to wait for long-term contraception or decide to get pregnant?

    <p>Lurasidone</p> Signup and view all the answers

    What is the recommended starting dose adjustment for patients with renal failure who are prescribed lithium carbonate?

    <p>Reduce the dose by at least 50%</p> Signup and view all the answers

    Which two drug classes can increase lithium levels?

    <p>NSAIDs and ACE inhibitors</p> Signup and view all the answers

    Which labs should be monitored for a patient on lithium?

    <p>Serum lithium level, renal function, and thyroid function</p> Signup and view all the answers

    When should a patient return for lithium serum level monitoring after an increase in their lithium dose?

    <p>$1-2$ days after the dose increase</p> Signup and view all the answers

    What is a common side effect of mood-stabilizing drugs that may require routine laboratory monitoring?

    <p>Nephrotoxicity</p> Signup and view all the answers

    What are the symptoms associated with increased negative affect due to 5HT and NE dysfunction?

    <p>Depressed mood, guilt, fear, anxiety, hostility, irritability, loneliness, appetite changes</p> Signup and view all the answers

    What is the starting dose requirement for patients with renal failure who are prescribed lithium carbonate (Lithobid)?

    <p>The starting dose should be reduced by at least 50%</p> Signup and view all the answers

    Which two drug classes can increase lithium levels?

    <p>NSAIDs and ACE inhibitors</p> Signup and view all the answers

    What medication should be taken with at least 350 calories of food for maximum absorption and may be used as a second-line treatment for new-onset bipolar disorder in women who do not want to wait for long-term contraception or decide to get pregnant?

    <p>Lurasidone</p> Signup and view all the answers

    What is required when prescribing mood-stabilizing drugs?

    <p>Both b and c</p> Signup and view all the answers

    What is the FDA requirement for all antidepressants?

    <p>Product labeling must contain information about potential risks of mania</p> Signup and view all the answers

    Which substance is mentioned in the text as decreasing lithium levels?

    <p>Caffeine</p> Signup and view all the answers

    When does a patient need to return for lithium serum level monitoring after an increase in their lithium dose?

    <p>After 2 weeks</p> Signup and view all the answers

    Which laboratory tests should be monitored for a patient taking valproic acid (Depakote)?

    <p>Serum valproate level, liver function, and CBC</p> Signup and view all the answers

    When should lithium serum levels be monitored after a dose adjustment?

    <p>5 days after the adjustment</p> Signup and view all the answers

    Which laboratory tests should be monitored for a patient taking carbamazepine?

    <p>Serum carbamazepine levels, renal and liver function, and CBC</p> Signup and view all the answers

    What is the recommended frequency for monitoring lithium levels in a stable patient?

    <p>Every 6 months</p> Signup and view all the answers

    Which laboratory tests should be monitored for patients taking atypical antipsychotics?

    <p>CBC and HbA1c</p> Signup and view all the answers

    What is a requirement when prescribing mood-stabilizing drugs to women of childbearing age?

    <p>Pre-conception and contraceptive counseling</p> Signup and view all the answers

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